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本文对硝普钠治疗慢性肺心病右心衰竭的某些理论和实践问题作了探讨。认为硝普钠虽然对慢性肺心病右心衰竭、特别是顽固性心衰有效,但因其藏轻心脏前负荷的作用是以体循环郁血为代价的,故效果不如治疗左心衰竭显著;而且有可能在投用后使动脉血氧分压下降。所以硝普钠不宜单独使用而应结合常规治疗原则的实施。在使用时必须重视其血液动力效应,做好中心静脉压的监护,以策安全。
This article discusses some of the theoretical and practical problems of sodium nitroprusside in the treatment of right heart failure in patients with chronic cor pulmonale. Although sodium nitroprusside is effective in patients with chronic cor pulmonale with right heart failure, especially with refractory heart failure, the effect of preloading of Tibetan light heart is at the expense of systemic blood stasis, so the effect is not as remarkable as the treatment of left heart failure. It is possible to drop the arterial oxygen pressure after administration. Therefore, sodium nitroprusside should not be used alone but should be combined with the implementation of conventional treatment principles. Must pay attention to its hemodynamic effects in use, good central venous pressure monitoring, in order to make safety.